Treatment is considered conservative when they are non-invasive such as medication or markedly less invasive such as manual therapy, injections or chiropractic or manual manipulation.
Generally, surgery is performed for back pain when conservative back treatments fail and the back pain and/or limb (arm, leg) pain persists for longer periods of time and the patient becomes unable to carry on his daily activities and is under continuous discomfort.
For most people an episode of lower back pain improves with non-invasive treatment within two weeks to three months. During this period when the back pain is resolving the patient must consider appropriate conservative treatment to reduce pain and spasms and manage sleeplessness or depression associated with back pain.
In certain cases conservative treatment is not the first option if:
- The patient loses bowel of bladder control and has progressive weakness in the legs. These symptoms require urgent medical attention.
- The patient has chronic lower back pain but an anatomical cause of the pain can not be identified.
- The patient has been involved in a major accident/trauma.
- The patient has a severe infection.
- It would be life or limb-threatening to delay surgery.
However, surgical emergencies for back pain are very rare and in most cases non-surgical treatments are used.
Non-surgical treatment options have many variations and you may need to try several treatments or a combination of treatments to find what works best for you. Sometimes few changes makes a lot of difference like ice application, heat therapy, OTC pain medication may provide substantial relief during bouts of severe pain.
Generally speaking, spinal disorders are very complex and require specialists. Spine clinics also include physical therapists, pain specialists and spine surgeons to treat various types of back pain.
Invasive treatment in spinal disorder is often the last resort, and considered when non-invasive techniques have failed.